Healthcare Provider Details

I. General information

NPI: 1316634553
Provider Name (Legal Business Name): DEBBIAN VENISIA REID NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 YORK AVE
NEW YORK NY
10021-5663
US

IV. Provider business mailing address

4027 MURDOCK AVE
BRONX NY
10466-2483
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-8690
  • Fax:
Mailing address:
  • Phone: 347-207-8602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number351487
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: